Positively represent the Company to both internal and external customers; always maintain a professional and courteous manner. Current unrestricted nursing license (RN) for state of residence. Proven ability to utilize Windows programs to include Word, Email, and Internet. ...
Serves as a resource to internal and external staff on issues related to utilization management. Insurance Managed Care RN - Case Manager. The Managed Care RN Utilization/Case Manager, under the direction of the Director of Managed Care serves a key role in coordinating the patient's/enrollees inter...
Apply clinical expertise when discussing case with internal and external Case Managers and Physicians. You will work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. Obtain clinical information to assess and expedite alternate levels o...
Key Responsibilities:Conduct telephonic assessments with obstetric patients for various health conditionsProvide care coordination and education to patients and familiesCoordinate care with healthcare professionals to promote continuity of careRequired Qualifications:Active, unrestricted Compact Sta...
We are hiring for a part-time Triage RN! This is a remote position working 24 hours per pay period (two-weeks) with occasional pick-up shifts available. ...
A company is looking for a Chronic Care Management Registered Nurse (Remote)....
Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. RN) and requires a leader who can assess, discuss, display, and train best-in-class services for our members and associates. The RN Supervisor will work closely with leaders in our operations and program area...
Key Responsibilities:Complete post discharge assessments for members' clinical and social needsEducate members on disease processes and medications, manage and update care plansCollaborate with healthcare providers and departments, work independently following program processesRequired Qualification...
We build local partnerships with shelters, food pantries, and other community-based organizations to turn them into a site of care. We help each other to learn and provide feedback using candor and kindness. Consult with Enhanced Care Management team about clinical concerns or questions, provide edu...
Active and unrestricted RN license for the state of South Carolina or compact license. The Company is committed to complying with the California Privacy Rights Act (“CPRA”) effective January 1, 2023; and all data privacy laws in the jurisdictions in which it recruits and hires employees. A Notice to...
Under the direction of the Manager, Quality Management Nurses, Quality Program Nurse (QPN), RN is responsible for the implementation of Quality Management policies, procedures, and activities. Quality Program Nurse, RN enforce DHCS regulatory requirements as pertaining to Facility Site Review (FSR) ...
Perform clinical coverage review services, which require interpretation of state and federal mandates, applicable benefit language and consideration of relevant clinical information Communicate all types of benefit determinations, including decisions RN, Nurse, Remote, Health, Healthcare. ...
Under the direction of the Manager, Quality Management Nurses, Quality Program Nurse (QPN), RN is responsible for the implementation of Quality Management policies, procedures, and activities. Quality Program Nurse, RN enforce DHCS regulatory requirements as pertaining to Facility Site Review (FSR) ...
RNs provide consultation, recommendations, and education as appropriate to non-RN case managers. This position will be supporting our Transition of Care (RN) program. We are seeking a candidate with a WA state RN license and Behavioral Health experience. Must be able to work independently with a qui...
Sharecare is the leading digital health company that helps people - no matter where they are in their health journey - unify and manage all their health in one place. Our comprehensive and data-driven virtual health platform is designed to help people, providers, employers, health plans, government ...
MGB Internal Resource Pool RN- Brigham and Women's Faulkner Hospital-(3269458). Our employees use the Mass General Brigham values to govern decisions, actions and behaviors. These values guide how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innov...
Acute Transition Care Manager, Registered Nurse (ATCM, RN) reports to the Acute Transition Care Management, Registered Nurse Manager (ATCM, RN Manager) and is responsible for providing proactive intervention and coordination of care to Vaya Health members and recipients (“members”) who are receiving...
This program aims to develop RN-to-BSN students to be ready for the real world. All of our RNs have exceptional clinical skills and have worked hard to become experts in the specialty skills required to treat infusion patients in their own homes. You must be enrolled in an RN-to-BSN program that has...
Enhance the experience of both internal and external customers by providing excellent customer service while maintaining production metrics. We’re connecting care to create a seamless health journey for patients across care settings. Goals of the program include providing a one-time outreach to memb...
Our Core Values - this is who we are, and who we are looking for to add to our team! Seek first to understand – must be intellectually curious, an active learner and listener, an innovative and resourceful problem solver. Live, Learn, Laugh, Love – We are seeking authentic individuals wi...
Active RN license in state of employment. If you have an RN or LPN license, you must have licensure for both states. ...
As a Telephone Transplant Case Manager RN with UnitedHealth Group, you'll support a diverse member population with education, advocacy and connections to the resources they need to feel better and get well. Current, unrestricted RN license in the state of employment. RN experience in a hospital, acu...
Acentra seeks a RN Clinical Assessor to join our growing team. Embark on a transformative career journey with Acentra Health as a Nurse Assessor. This is a PRN Hybrid role that will entail working from your home office while also dedicating a portioneach day to fieldwork. Must have an active Registe...
The unique talents, perspectives, and experiences of our community enrich the learning, and working environment at OU, inspiring us to harness our innovation, creativity, and collaboration for the advancement of people everywhere. The RN Care Manager is responsible for all aspects of care for comple...
Humana”) offers competitive benefits that support whole-person well-being.Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work.Among our benefits, Humana provides medical, dental and...